Exposure to PCP can increase the prevalence of life-threatening events. However, exposure to tainted marijuana cigarettes potentially precipitates organ failure, including respiratory failure. 3Ĭannabis is not typically considered to be a drug that causes respiratory failure. At that time, PCP was referred to by marijuana users and dealers as “embalming fluid.” It is postulated that drug dealers subsequently and mistakenly began using genuine embalming fluid to augment marijuana cigarettes, and that this has led to the current formulation with embalming fluid, PCP, or both. The “wet” cigarettes reported on in the 1970s were probably laced with PCP. The exact origin of tainted marijuana cigarettes is unknown. The most frequently reported method involves the dipping of marijuana into embalming fluid or formaldehyde that has been mixed with phencyclidine (PCP). The precise ingredients involved in this augmentation process may or may not be known by the end user. “Wet” cigarettes are conventional marijuana cigarettes that have been dipped into various fluids or laced with additional substances. 1–4 This altered form of marijuana, referred to in the vernacular as “wet,” “illy,” or “fry,” was first reported in the 1970s and can now be procured rather readily. 1–5 Several reports indicate the increased use of marijuana cigarettes, the ingredients of which have been tainted in a potentially harmful fashion. Numerous reports on alternative forms of tetrahydrocannabinol (THC) can be found in multiple media forums. We believe that, in young adults with an unexplained presentation of severe respiratory failure, the possibility of exposure to tainted marijuana cigarettes should be considered. To our knowledge, this is the first 2-patient report of severe respiratory failure and rescue therapy with extracorporeal oxygenation after the smoking of marijuana cigarettes thus tainted. After lengthy hospitalizations, both patients recovered with only mild pulmonary function abnormalities. In both patients, progressive hypoxemic respiratory failure necessitated rescue therapy with extracorporeal membrane oxygenation. We report the cases of 2 young adults who presented at our hospital with respiratory failure soon after they had smoked “wet” marijuana cigarettes. Inhaling smoke from these cigarettes can cause lung injuries. Marijuana cigarettes are dipped into or laced with other substances, typically formaldehyde, phencyclidine, or both. Reports have suggested that the use of a dangerously tainted form of marijuana, referred to in the vernacular as “wet” or “fry,” has increased.
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